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9 September, 2019 00:00 00 AM

Frequently Asked Questions about menopause

WebMD Medical Reference
Frequently Asked Questions about menopause

What is menopause?

Menopause is a normal condition that all women experience as they age. The term "menopause" can describe any of the changes a woman goes through either just before or after she stops menstruating, marking the end of her reproductive period.

What causes menopause?

A woman is born with a finite number of eggs, which are stored in the ovaries. The ovaries also make the hormones estrogen and progesterone, which control menstruation and ovulation. Menopause happens when the ovaries no longer release an egg every month and menstruation stops.

Menopause is considered a normal part of aging when it happens after the age of 40. But some women can go through menopause early, either as a result of surgery, such as hysterectomy, or damage to the ovaries, such as from chemotherapy. Menopause that happens before 40, regardless of the cause, is called premature menopause.

How does natural menopause happen?

Natural menopause is not brought on by any type of medical or surgical treatment. The process is gradual and has three stages:

Perimenopause. This typically begins several years before menopause, when the ovaries gradually make less estrogen. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last 1 to 2 years of perimenopause, the drop in estrogen quickens. At this stage, many women have menopause symptoms.

Menopause. This is the point when it's been a year since a woman last had her last menstrual period. At this stage, the ovaries have stopped releasing eggs and making most of their estrogen.

Postmenopause. These are the years after menopause. During this stage, menopausal symptoms such as hot flashes ease for most women. But health risks related to the loss of estrogen rise as the woman ages.

What conditions cause premature menopause?

Premature menopause can be the result of genetics, autoimmune disorders, or medical procedures. Other conditions that may cause early menopause include:

Premature ovarian failure. Normally, the ovaries make both estrogen and progesterone. Changes in the levels of these two hormones happen when the ovaries, for unknown reasons, prematurely stop releasing eggs. When this happens before the age of 40, it's called premature ovarian failure. Unlike premature menopause, premature ovarian failure is not always permanent.

Induced menopause. "Induced" menopause happens when the ovaries are surgically removed for medical reasons, such as uterine cancer or endometriosis. Induced menopause can also result from damage to the ovaries caused by radiation or chemotherapy.

What are the symptoms of menopause?

Most women approaching menopause will have hot flashes, a sudden feeling of warmth that spreads over the upper body, often with blushing and some sweating. The severity of hot flashes varies from mild in most women to severe in others.

Other common symptoms around the time of menopause include:

Irregular or skipped periods

Insomnia

Mood swings

Fatigue

Depression

Irritability

Racing heart

Headaches

Joint and muscle aches and pains

Changes in libido (sex drive)

Vaginal dryness

Bladder control problems

Not all women get all of these symptoms.

How do I know when I'm going through menopause?

Either you'll suspect the approach of menopause on your own, or your doctor will, based on symptoms you've told her about. To help figure it out, your doctor can do a certain blood test.

It also helps if you keep track of your periods and chart them as they become irregular. Your menstrual pattern will be an added clue to your doctor about whether you're premenopausal.

What long-term health problems are tied to menopause?

The loss of estrogen linked with menopause has been tied to a number of health problems that become more common as women age.

After menopause, women are more likely to have:

Osteoporosis

Heart disease

A poorly working bladder and bowel

Greater risk of Alzheimer's disease

Poor skin elasticity (increased wrinkling)

Poor muscle power and tone

Some weakening in vision, such as from cataracts (clouding of the lens of the eye) and macular degeneration (breakdown of the tiny spot in the center of the retina that is the center of vision)

A number of treatments can help lower risks that are linked with these conditions.

These are some frequently asked questions and answers about menopause to discuss with your doctor.

My hot flashes aren't as intense as the ones my friends describe. Is this normal?

While hot flashes (or flushes) are very common in perimenopause, not all women experience them, and not all flashes are of the same intensity. Hot flashes can be as mild as a light blush or severe enough to wake you from a sound sleep and be associated with perspiration (called night sweats). Most hot flashes last 30 seconds to five minutes. They usually disappear within a few years after menopause, but in some women they can continue for decades.

Now that I've begun menopause, should I be concerned about birth control?

You will know for sure that you have experienced menopause when you have not had your period for an entire year. Until you have gone one year without a period, you should still use birth control if you do not want to become pregnant. After menopause, you should continue to practice safe sex techniques by using latex condoms to reduce the risk of sexually transmitted infections.

I'm perimenopausal and have been told I should be taking low-dose birth control pills. Why?

It is common in perimenopause to be given medications to regulate cycles and a common medication given is the lower dose birth control pill. Compared to regular birth control pills, the lower dose of estrogen in very-low-dose pills may be safer for perimenopausal women. (Perimenopause typically begins several years before your final period.) While regular birth control pills contain 30 to 50 micrograms of estrogen, these low-dose pills contain only 0.3 to 0.45 micrograms and can be increased as needed.

What are some of the benefits of taking low-dose birth control pills?

In addition to preventing pregnancy, the pills can often regulate heavy or irregular menstrual periods and may provide protection from ovarian and uterine cancer. The pills may also prevent bone loss, which can lead to osteoporosis. However, women with a history of breast cancer, blood clots, or heart disease, or women who smoke, should not take these pills.

Should I take Hormone Replacement Therapy?

Hormone replacement therapy (HRT) is designed to help women whose menopausal symptoms -- hot flashes, night sweats, insomnia, mood swings, vaginal dryness -- are severe and affecting her quality of life. These symptoms can go on for years after your last period.

HRT replaces or supplements the hormones your body doesn’t make anymore. Most women who use it take a combination of estrogen and progesterone. Estrogen is what helps most with symptoms like hot flashes and vaginal dryness; progesterone is added to protect against uterine cancer and bone loss (osteoporosis).

Besides hormone replacement therapy, how can I treat hot flashes?

While HRT relieves hot flashes for many women, there are other drug treatments that may offer relief. These include both over-the-counter and prescription therapies you may recognize for their more common medical uses. Over-the-counter therapies include various vitamins, ibuprofen products, and soy protein found in foods.

Prescription treatments include:

HRT

Low-dose depression drugs fluoxetine (Prozac), paroxetine (Paxil), or venlafaxine (Effexor)

Clonidine, blood pressure medication

Gabapentin, anti-seizure drug

Brisdelle, a paroxetine formula specifically for hot flashes

Duavee, a conjugated estrogens/bazedoxifene formula designed to treat hot flashes

Are there natural treatments available for menopause symptoms?

Natural or bioidentical supplements containing compounds that act like estrogens -- such as soybeans or wild yams -- may provide some of the benefits of estrogen in relieving menopausal symptoms. They commonly include estradiol, estrone, estriol, progesterone, testosterone, and dehydroepiandrosterone (DHEA). These products are notregulated by the US Food and Drug Administration (FDA and the dose of hormones can vary from batch to batch.

Other botanicals, including black cohosh, have shown some promise for reducing menopausal sweats, or hot flashes. You should always check with your doctor before using any of these supplements.

Sex has become painful since menopause. What can I do?

The pain you are experiencing during sex is may be due to vaginal dryness associated with declining estrogen levels during menopause. Talk to your doctor about possible causes of painful intercourse. There are a number of lubricants you can try to relieve the symptoms. Ask your doctor or pharmacist for a suggestion. There are also local estrogen treatments -- cream, tablets, and an estrogen ring -- that treat vaginal dryness. A oral drug taken once a day, Osphena, is also available. The drug makes vaginal tissue thicker and less fragile, resulting in less pain for women during sex.

Can menopause cause changes in a woman's voice?

The majority of women do not experience a voice change during menopause, although this may be a problem for some.

What can I do about facial hair I've developed as a result of menopause?

Botanical supplements containing compounds that act like estrogens -- such as soy -- may provide some of the benefits of estrogen in relieving menopausal symptoms, but research results are contradictory.

Other botanicals, including black cohosh, have shown some promise for reducing menopausal sweats, or hot flashes. However, more research is needed to define the benefits and risks of these alternative treatments, and you should always check with your doctor before using them.

 

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Editor : M. Shamsur Rahman

Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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